Wiki Stable vs unstable chronic condition

[hanihosni]

Hello,

A patient presents for an E/M visit and he has chronic pain for which he takes analgesics. The pain is being described as tolerable, or 4/10 instead of 8/10 in severity, while the medication is taken. Is that condition considered stable or unstable (since the pain level is tolerable or 4/10 but it's still there and did not resolve) ? It is stated in the guidelines that as long as the symptoms have not reached the baseline, the condition is considered unstable. In this case can "tolerable" be considered baseline or does it have to be resolved ?

Hani E.

 

[jkyles]

Hello,

A patient presents for an E/M visit and he has chronic pain for which he takes analgesics. The pain is being described as tolerable, or 4/10 instead of 8/10 in severity, while the medication is taken. Is that condition considered stable or unstable (since the pain level is tolerable or 4/10 but it's still there and did not resolve) ? It is stated in the guidelines that as long as the symptoms have not reached the baseline, the condition is considered unstable. In this case can "tolerable" be considered baseline or does it have to be resolved ?

Hani E.

Hi there, I'm not sure which guidelines you're looking at, but you'll need to know the treatment plan to determine whether the patient is stable. The CPT manual states in part:

"Stable" for the purposes of categorizing MDM is defined by the specific treatment goals for an individual patient. A patient who is not at his or her treatment goal is not stable, even if the condition has not changed and there is no short-term threat to life or function. For example, a patient with persistently poorly controlled blood pressure for whom better control is a goal is not stable, even if the pressures are not changing and the patient is asymptomatic

Chronic pain is an example of a condition that might be stable even though it not completely resolved.

Unfortunately, the goal for a chronic pain patient might be something like the patient's pain is below a certain level and/or the patient is able to perform certain activities, rather than patient has no pain at all. But again, you'll need to look at the treatment plan.